女性盆腔解剖及TVT,TVT-O治疗女性SUI__培训课件.ppt

GYNECARE TVT * The TVT Device is a PROLENE* polypropylene mesh tape, that is covered with a plastic sheath and attached to two stainless steel introducer needles. The device when used in conjunction with the TVT Introducer and TVT Rigid Catheter Guide make up the TVT System. GYNECARE TVT * The protected mesh attached to introducer needles ready for the application. GYNECARE TVT * This is a reusable instrument. . . GYNECARE TVT * This guide fits a standard 18 Fr Foley catheter. The guide passed into the bladder through the urethra, allows mobilization of the bladder neck and urethra away from the path of the TVT device. GYNECARE TVT * Patients are counseled about the potential risks and benefits of the procedure. The procedure is in most cases an ambulatory one, and complications are minimal. Risks include bleeding in the vagina or retropubic space, infection in the vagina or urinary tract, and injury of the bladder. Patients are prepared for an overnight stay, although discharge the same day is the norm. GYNECARE TVT * Patients are NPO for 24 hours before the procedure. Prophylactic antibiotics which cover urinary tract pathogens are administered, and aspirin and other anticoagulants are discontinued for an adequate period before surgery. GYNECARE TVT * Preparation includes positioning and anesthetizing the patient. GYNECARE TVT * The patient is draped and placed in dorsal lithotomy. Insert 18 fr catheter and empty bladder. GYNECARE TVT * A tension test that requires patient participation is conducted during the TVT procedure. Therefore it is recommended that the TVT procedure be preformed under local anesthesia with IV sedation. However, regional or general can be used. If it is your choice to use regional, selection of anesthesia should be made with the understanding that the patient will need to cough during the procedure. It is recommended that the surgeons should work closely with the anesthesiologist to choose a regional that will not relax the